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Content archived on 2024-04-30

Measuring and monitoring staff performance in reforming health systems


The management of human resources is an essential component of an effective health system and can be the most important factor influencing success or failure of health sector reform. Traditionally much emphasis has been attached to the areas of work force planning, management training and design of supervision systems as a means to improve overall health systems performance. While competency in these areas is necessary it is not sufficient to meet the challenge of reprofiling human resources in the context of broad-based developments and reforms, such as demographic change, decentralisation, new partnerships with the private sector and changes in the financing of health services.

General and specific objectives

The general objective of this research is to identify, document and adapt systems to measure, monitor and enhance the performance of health staff working in the public sector of developing countries which are undergoing health care reforms. The sources for the performance enhancement systems to be developed will be models and experiences being currently used in developing and European health systems, as well as any innovative approaches that can be identified from a sample of private sector health and service organisations.

Specific objectives of the research are:

I. To identify methods used to monitor and enhance performance in a sample of health systems from developing countries and European countries;
II. To compare methods being used within public and private (for profit and not for profit) sector health and service-oriented organisations in developing and European countries:
III. To categorise and disseminate the variety of methods identified and put this knowledge at the disposal of policy makers and practitioners with responsibilities for human resource management in health systems;
To assess the potential applicability and utility of identified performance enhancement and monitoring systems by pilot testing a sample of them in a developing country situation;
Expected Outcome

The overall aim of the project is to identify methods of managing and monitoring staff performance which have greater applicability and utility to health systems in developing countries. It is anticipated that there will be considerable demand from ministries of health, managers and researchers both for the output from the review and categorisation of approaches, and for the results of the pilot testing of approaches in the four developing countries. To meet this demand, and ensure that dissemination is comprehensive, it is planned to publish the output of the literature review and results of the first workshops complemented by the publication of articles in relevant international and country journals.
The investigation will consist of five phases with a total elapsed time of 36 months. Phases 1 and 2 can be seen as Step 1 : gathering information to develop models of Performance Management Systems; and phases 3-5 as Step 2 : developing and testing PMS models. Phase 1, the Preliminary phase will last for 3 months. This phase will attempt to identify and map out the options in the use of staff performance management in health systems, and will provide the context for detailed case studies in phase 2.

Phase 2 will last for 9 months and will examine the current practice of monitoring and managing staff performance in health and other service industries in both developed and developing countries, and in the public and private (for profit and not-for-profit) sectors. This phase will address Research Objectives I and II.

Phase 3 will be the development of appropriate modes for testing in four African public health systems. This phase will address Research Objective III and will last for 2 months.

Phase 4 will be the testing of the models. This part of the investigation has a clear regional focus with studies carried out in Zambia, Ghana, South Africa and Mozambique.

Call for proposal

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EU contribution
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Pembroke Place
United Kingdom

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Participants (5)